Effectiveness and Safety of Baricitinib as a Covid-19 Drug Candidate: A Systematic Review

Baricitinib is an approved selective JAK1/JAK2 inhibitor that can potentially inhibit IL-6 as the primary driver of COVID-19-related cytokine storm syndrome. Therefore, this study aimed to assess the effectiveness and safety of baricitinib therapy in COVID-19 patients. It was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search for eligible articles reporting the efficacy and safety of baricitinib on COVID-19 patients, published up to May 2021, was conducted using PubMed and Embase. The research protocol was registered at PROSPERO (CDR42021235282), and data were presented in a metasynthetic (descriptive) manner. Out of 878 identified articles, seven were eligible and consisted of three randomized clinical trials, one quasi-experimental study, two before-after (pre-post) studies, and one cross-sectional study. The articles suggested that baricitinib could improve the clinical conditions of COVID-19 patients indicated by negative PCR test results, improve breathing quality, and decrease: ICU requirements, length of hospital stay, as well as the risk of death. The trial studies showed that this inhibitor works better with a loading dose of 8 mg, continued with 4 mg daily. Baricitinib could also produce synergistic effects with standard therapy such as corticosteroid and remdesivir. Therefore, it is a promising candidate therapy for COVID-19 patients, but since the number and methodological quality of the studies are low, further and better research is needed to ascertain its potential use on COVID-19.